DAVID A MACK DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052181

License Status

INACTIVE

Business

First Name

DAVID A

Last Name

MACK

Suffix

Business Name

DAVID A MACK DO

Original Issue Date

11/21/1975

Effective Date

11/21/1975

Expiration Date

07/31/1987

City

THE DALLES

State

Zip

97058

County

OREGON

Ever Disciplined

LastModifiedDate

09/20/2006